Résumé
Objective To investigate the prevention and management of anastomotic leakage in patients with middle and lower rectal cancer after neoadjuvant therapy.Methods In this study,50 cases of middle or lower rectal carcinoma underwent anus preserving radical resection and anastomosis after a 4 cycles of chemotherapy with FOLFOX and 46 Gy(2 Gy×23)radiotherapy.Anastomotic leakage,the prevention and management of this complication were analyzed retrospectively.Results All these 50 patients received low anterior resection after chemoradiotherapy,among the 19 cases receiving prophylactic ileac stoma simultaneously,there was no anastomotic leakage,whereas anastomotic leakage developed in 4 out of the 31 patients who did not receive prophylactic ileac stoma,including concomitant rectovaginal fistula in 2 cases.All these fistulae were cured conservatively.Conclusion Concomitant treatment of FOLFOX regimen and RT in neoadjuvant setting of rectal cancer could increase the rate of anal interior sphincter reservation,prophylactic ileac stoma helps to reduce the rate of anastomotic leakage after a anus-preserving low anterior resection of the cancer.
Résumé
Objective To study the therapeutic effect of catgut net wrapping for preservation of the injured spleen.Methods Catgut net wrapping method was used to preserve the injured spleen,and the clinical material of those patients treated by the wrapping method was retrospectively evaluated.Results Ultimate spleen recovery was achieved in each case of 15 patients without postoperative bleeding observed,any abscess formation,or complications related to the use of catgut net wrapping.The patients were discharged after 10 to 14 hospital dayS.Two-week-fol-low-up results showed this therapeutic opinion is safe.Conclusion As a means of preserving the injured spleen,the catgut net wrapping method was simple,safe,and efficacious.